Disability Insurance & Employee Benefits Lawyers

Social Security Disability Benefits Attorney

What is Social Security Disability Benefits?

Social Security Disability Insurance (SSDI) is a Social Security Administration (SSA) program intended to pay monthly benefits to you in the event you become disabled before you reach retirement age and aren’t able to work. SSDI benefits are eligible only to those with a severe, long-term, total disability. There are specific requirements surrounding qualifying and being approved for a Social Security Disability Benefits claim through the Social Security Administration. If you have been denied, you need an experienced Social Security Disability Benefits Attorney on your side. Click below to read more about SSD Benefits.

Common Social Security Disability Injuries

Federal Social Security laws maintain a strict definition of a disability. According to the Social Security Administration, to receive a disability benefit, you must prove the following:

You cannot do any substantial work because of your medical condition.

This condition or conditions has lasted, or is expected to last, at least 1 year, or to result in your death.

The administration assesses the overall ability of the claimant to engage in employment. During this analysis of whether the claimant receives disability benefits, the administration uses a specific set of regulations and listings describing certain conditions or diseases.

These include:

Musculoskeletal disorders

Growth impairments

Vision disorders

Balance and hearing disorders

Speech disorders

Breathing disorders

Heart and blood vessel diseases

Digestive system diseases

Kidney diseases

Blood and lymphatic diseases

When applying for disability benefits, the applicable agencies may request applications for disability benefits. This application will require several forms and may entail a face-to-face interview.

Medical Evidence and Social Security Injuries

However, a disability claim will also require the claimant to provide sufficient medical evidence to show the extent of the above injuries are sufficient to receive disability benefits.

Agencies will ask for some or all of the following information:

Your medical assistance number, if applicable.

The contact information for the doctor/HMO/therapist that treated the illnesses, injuries, or conditions, or the information for the individual you expect to treat you in the future.

A list of hospitals, clinics, or emergency rooms you visited.

A list of medications and medical tests you have had.

If the evidence is not available or insufficient to make a determination, the agency may request a consultative examination.

Types of Disability Claims Administered by the Social Security Administration

SSI (Supplemental Security Income) – For individuals under age 65 who become disabled. Claimants must meet certain poverty requirements before their claim will be considered (i.e., no more than $2000 in assets for individuals, $3000 for couples, excluding the home where they live and necessary cars, etc.) Benefits are adjusted for income. Individuals eligible for SSI also get Medicaid.

Children’s SSI – For families with disabled children that meet certain poverty requirements; if they do, a child may receive SSI if he or she is disabled. The test for whether or not a child is disabled is different, and usually harder to meet, than for adults.

DIWC (Disabled Insured Worker’s Claim) – A disability program for adults who have worked enough to have “insured status” under the Social Security System. For disability, a worker must have worked above a minimum amount 5 out of the last 10 years (as measured in quarters of years). A person does not have to file before their work credits run out, but he or she must be found disabled before the work credits run out. Individuals who are eligible for insured disability benefits get Medicare.

DIWW (Disabled Insured Widow’s/Widower’s Claim) – An individual must be 50 years old, be found disabled, and have been married to a person who was insured when that person died to file this type of claim. The widow/widower must also become disabled within 7 years of their spouses death. There are special rules when the spouse draws benefits on behalf of children that extends the 7 years, so it does not start until the children are grown. If a prior divorced spouse dies, the disabled person must have been married to the deceased spouse seven years. If the Widow/Widower is 60 or over, and meets the other requirements, then he or she does not have to be found disabled.

DAC (Disabled Adult Child) – A child of an insured worker can draw benefits if he or she is found disabled before age 22 (or found to have become disabled before age 22 if he or she applies later). The child’s parent must have died while insured or become disabled and drawing insured status. A DAC who is drawing benefits will lose them if he or she gets married to someone other than another person drawing insured disability benefits.

SSDC (Supplemental Security Disability Claim) – This is not a separate type of claim, but it is the name of the type of claim for an individual worker who is both insured and meets the poverty requirements for SSI.

The amount and type of Social Security disability benefits you receive is determined by a complex process and depends upon many factors, including the following:

The length of time you have spent in the work force

Your ability to return to employment of any type after disability

Your earnings prior to the disability

The availability of disability benefits and income from other sources

The extent to which you are willing to undergo an often-complex appeals process to ensure you receive the Social Security disability benefit you deserve

Individuals pursuing disability & Social Security income need to understand that many initial disability claims are denied. Your chances increase by retaining an experienced disability lawyer to file the initial claim—or to help with the complex appeals process if your initial claim is denied. With two attorneys certified as Social Security Disability Specialists by the National Board of Social Security Disability Advocacy, the law firm of Eric Buchanan & Associates, PLLC can help pursue the disability benefits you need. Though we are located in Chattanooga, Tennessee, we service clients thoughout the United States and help them obtain the benefits they deserve.

Who Is Entitled to Social Security Disability Benefits?

Social Security is a program of the U.S. federal government that pays benefits to people unable to work due to a medical condition. Disability law states this must be a medical condition expected to last at least one year or result in death. Federal disability laws require this very strict definition of disability. Furthermore, according to Social Security law, some family members of disabled workers may also receive a Social Security disability benefit.

While some programs provide Social Security disability benefits to individuals suffering from partial or short-term disability, Social Security does not.

Social Security Disability Benefits for Dependents

When an adult is approved for Social Security disability benefits, unmarried dependent children under age 18—or up to age 19 if still attending secondary school—may qualify for benefits as well. Dependents can expect the benefits to be subject to certain limitations. The disability benefit is capped at 50 percent of the initial amount, and subject to a family maximum. The Social Security Administration applies a complex formula to arrive at how the family maximum affects each beneficiary, but $1,830 is the top monthly family maximum for 2010.

Benefits for Family Members

Under Supplemental Security Income (SSI) disability law, certain family members related to a disabled individual may also qualify for a Social Security benefit. These include the following relatives of the disabled:

A spouse, if 62 or older, or of any age if caring for a child of the disabled who is younger than age 16 or is also disabled;

An unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild, who is under 18 or 19 if attending elementary or secondary school full time;

An unmarried child, age 18 or older, if s/he has a disability that started before age 22;

In some instances, a divorced spouse may qualify for benefits if s/he was married to the disabled individual for at least ten years, is not currently married, and is at least age 62 .

Qualifying for SSDI Benefits

Earnings Requirements for Disability Benefits

Social Security laws state that, in order to receive disability benefits, you must meet two separate earnings tests:

A recent work requirement based on your age at the time you became disabled

A duration of work test that shows you worked long enough to receive Social Security benefits

Certain workers who are blind need only meet the duration of work test according to Social Security laws.

Work Credits

The number of work credits you need to qualify for SSDI depends on how old you are when you become disabled. If you are under 30 when you become disabled, you need to have earned at least one work credit per year since you left school. For people over 30, you need to have earned 20 work credits out of the last 40 possible quarters of a year. In other words, you need to have worked five out of the last ten years.

If you do not have enough work credits, you might qualify for Supplemental Security Income (“SSI”), but those benefits are only paid to people who are disabled and who are extremely poor. Basically, you must have less than $3000 in non-exempt assets for a married couple or $2000 for an individual.

This is technically stated as: “Is the claimant engaged in substantial gainful activity (SGA)?” § 404.1520(b) and § 416.920(b). SGA is in turn defined as earning above the cut-off set out in the regulations, currently approximately $850 per month.

Medical Eligibility

The individual must have a medical condition that meets the SSA’s definition of disability. SSDI benefits are eligible only to those with a severe, long-term, total disability.

Severe means that the condition interferes with basic work-related activities.

Long-term means that your condition has lasted is expected to last at least one year.

Total disability means that the individual is no longer able to perform substantial gainful activity for at least one year.

Additionally, if the individual is currently working and making over a certain amount ($1,130 per month in 2016 for disabled applicants, $1,820 for blind applicants), the SSA will find that he or she is not disabled enough to qualify for SSDI benefits.

How Does the Social Security Agency Determine If I Am Disabled?

Social Security law requires that all received applications are reviewed. First, the Social Security Administration confirms the applicant meets basic requirements and worked enough years according to disability law and evaluates whether the applicant is currently working. Applications that pass this stage move on to the Disability Determination Services office in the applicable state. In accordance with disability laws, Eric Buchanan & Associates works closely with doctors and specialists to consider the medical evidence regarding:

The medical condition

When this condition began

How this condition limits activities

Medical test results

Treatment

To make a disability benefit judgment, the state agency staff may ask for additional tests.

How the Decision is Reached

Social Security laws require the agency use a five-step process to decide if whether or not an applicant is sufficiently disabled to receive disability benefits.

Is the applicant working, and do their earnings exceed a certain amount?

Is the medical condition severe enough?

Is the applicable condition on the List of Impairments?

Can the applicant perform the work they did before the injury?

Can the applicant do any other type of work?

There are many additional rules regarding Social Security benefits for applicants who are blind or visually impaired.

When the state agency reaches a decision regarding a Social Security disability benefit, it informs the applicant via mail. Letters of approval show the amount of the Social Security benefit and the timeframe in which they start. Otherwise, the letter explains the appeals process for Social Security disability benefits. Contact Eric Buchanan & Associates, PLLC, Attorneys at Law, to discuss your Social Security disability claim application.

It is extremely difficult to qualify for these benefits. Even if you are approved for disability benefits, you won’t receive SSDI benefits until you have been disabled for five complete months. If you are approved right away (for instance, because you just had a liver transplant), you would still have to wait five months for your checks to start.

However, it’s more likely you wouldn’t be approved for about six months to a year (after at least one level of appeal). In that case, when you finally get approved, you would be paid disability back pay starting with the sixth month after your disability began (your disability onset date). If you are denied, as many people are, you can appeal, but it can take as much as two to three years before your case goes before a Social Security Administrative Law Judge (“ALJ”), which is historically your best chance to win.

Social Security’s Five Step Sequential Evaluation Process

At each level of the Social Security appeals process, the Administration considers the following steps to determine if a claimant is disabled (See 20 C.F.R. § 404.1520 for Title II cases (i.e. disability insurance benefits) and 20 C.F.R. § 416.920 for Title XVI cases (i.e. SSI cases):§ 404.1505 Basic definition of disability.

The law defines disability as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.

1. Is the claimant working?

2. Does the claimant have a severe impairment?

Basically, a severe impairment is a medical or physical impairment (or combination of impairments) that is supported by objective evidence that would “significantly limit” a persons ability to do basic work activities. The threshold for this step is relatively low, as long as there is objective evidence of the impairment.

3. Does the claimant meet or equal a listing?

20 C.F.R. Pt. 404, Subpt. P, App. 1 is a part of the Social Security Regulations that contains a list of certain medical conditions that result in an “automatic” finding that a claimant is disabled. These are usually very hard to meet, because even when a claimant is extremely ill or disabled, often their problems have not been documented to the extent that is required by the listing.

4. Can the claimant perform his or her past work?

A claimant is found to not be disabled in he or she can perform “past relevant work.” This is usually defined as work performed within the last 15 years, and it must have been performed long enough for the claimant to have learned the job. The tricky part of this step is that a person can be found to be able to do the “kind” of past work they have done. 20 C.F.R. § 404.1560(b). The distinction there is that a person’s individual job may have had more demanding requirements than that particular job usually has in the economy, so that a claimant can be found “not disabled” if the claimant can’t do the same job done in the past, but can do the job as it is usually performed.

5. Can the claimant perform other work?

If the claimant can’t do past work and all the other steps above are satisfied, then the burden shifts to the Social Security Administration to show the claimant can perform other work in the economy. The majority of cases are decided at this step. The Commissioner may meet his burden by relying on the testimony of a VE or by relying on the “Grid” regulations. 20 C.F.R. Pt. 404, Subpt. P, App. 2 (the “Grids”) are a set of charts found in the regulations that consider a persons age, education, previous work experience, and previously acquired skills and dictate a finding of disabled or not.

Have You Recently Been Denied Your Social Security Disability Benefits?

Anyone facing a long-term or permanent disability has a tough road to travel. Learning to live when a condition limits your ability to earn a living or care for yourself or your family is overwhelming. While resources are available to provide monetary compensation to pay for the help you need, you must deal with insurance companies fighting to protect their bottom line or government agencies whose red tape makes it difficult to get valid claims accepted. You need a disability lawyer with the skills and experience to explore every available option and fight hard to pursue the compensation you need. Remember, you only have 60 days to file an appeal, so don’t wait – contact our office immediately.

Denial of Social Security Disability Benefits

If your application for SSD is denied (most initial applications are), you can appeal the decision. You have to request a review of the denial within 60 days of when you receive the denial letter. The first step of the appeal process in most states is the Request for Reconsideration, a review of your file by another claims examiner. If you are denied again, you can appeal to the next stage by requesting a hearing with an administrative law judge who works for the SSA.

Disability Appeal Process – The Levels of Appeal for Social Security Cases

Initial Application:

The claimant must sign a written application (except in very unusual circumstances) and complete paperwork explaining his or her disability and listing medical treatment. The case is sent to the state DDS (Disability Determination Service) to be evaluated under Social Security’s rules. If a claimant is denied at this step, the claimant usually has 60 days to appeal to the next level.

Reconsideration:

The claimant’s case is sent back to DDS to be “reconsidered.” If a claimant is again denied at this step, the claimant has 60 days to appeal to the next level.

Hearing level:

If the claim is denied at the reconsideration level, Social Security law stipulates the claimant request a hearing. The claimant’s case is sent to the local Office of Disability Adjudication and Review (formerly the Office of Hearings and Appeals), where the case is assigned to an Administrative Law Judge (ALJ) who will hear the case and who is not bound by any prior decisions. The ALJ has a duty to ensure unrepresented client’s cases are fully developed, but ODAR will usually rely on an attorney to provide medical evidence for the file. The ALJ will issue a detailed, written decision. Unfortunately the wait time for this hearing may exceed two years and depends on the particular office. Prior to the hearing, submit or update all medical evidence relevant to the case as the ALJ will also close the record, and at that time it can become very difficult to get any additional medical evidence in to the record once the ALJ’s decision has been issued. If it is unfavorable, the claimant has 60 days to appeal to the Appeals Council by filing a Request for Review. (If the same case has previously been remanded by the Appeals Council to the ALJ to deadline is only 30 days to file written exceptions to the Appeals Council).

Appeals Council:

This is an administrative appellate level that is made up of “administrative judges” who are not full ALJ’s; however, they review the file and any written arguments made. They may also consider new evidence, but there must be “good cause” for not having submitted it earlier. This level can take as much as two years, and occasionally more. The Appeals Council may reverse the ALJ and issue a fully favorable decision, or remand the case to the ALJ for further proceedings. In most cases, the Appeals Council issues a form letter denying the Request for Review, and the ALJ’s decision becomes the final decision of the Commissioner. If the Request for Review is denied the claimant has 60 days to seek judicial review in Federal Court if the case merits that level of review.

Federal Court review:

The standards for review by a Court are limited. See 42 U.S.C. 405(g). The Court may only overturn the Commissioner’s decision if the Court finds the decision was not based on substantial evidence or that the Commissioner made an error of law. There is no de novo review. The Court is empowered to reverse the Commissioner’s decision, but in many cases the case is sent back for a new hearing. The Court will also very often uphold the Commissioner’s decision.

Court of Appeals:

If a case is denied at the District Court level, a claimant may proceed to the Court of Appeals. This is a very rare case, and few cases are won at this level. Recent statistics have shown an affirmance rate of Social Security denials as high as 98%.

According to the disability laws of most states, the next step is to appeal using a document called a Request For Reconsideration. Disability law usually stipulates this be filed within 60 days of the application denial date. The same agency that denied the initial application receives the reconsideration and may well deny this, too, usually within 90 days.

Disability Laws and Regulations

Remember that the laws and regulations governing Social Security disability are quite complex. It will never suffice to simply prove that you cannot perform your old job. The fact of the matter is that those claimants represented by Social Security lawyers are approved at much higher rates than those who proceed without representation. Improve your chance of acceptance and contact an attorney at Eric Buchanan & Associates, PLLC to discuss your Social Security disability situation.

Do I Need an Attorney to Apply for or Receive Social Security Disability Benefits?

Legally, you do not need to retain a Social Security Disability Benefits attorney to file a disability claim. However, 70 percent of all SSD and SSI disability claims, represented or otherwise, are denied at application. In such instances, it can be very helpful to retain the services of a Social Security disability attorney to assist with your appeal.For example, many individuals filing a disability claim make the mistake of filing a brand new application upon rejection of the initial application. This will almost certainly be rejected out of hand, because there is a specific process for filing appeals to rejected applications, instead of submitting duplicate applications. Experienced disability attorneys can help novices avoid such mistakes when filing for a disability claim or a disability benefit.

When fighting for your disability benefits, Social Security disability lawyers can provide the following benefits to their clients:

Increased chances of winning claims and benefits

Skill and experience processing Social Security disability cases

What does this mean if you are an SSD and SSI applicant who is disabled and in search of help? Even learning everything one can about the benefit approval system might not be the best way to improve the chances of successfully filing an application. An experienced disability attorney may be necessary in order to actually receive the benefits for which one is applying.

When Searching for a Social Security Disability Attorney, Look for the Following

Understanding of Social Security Administration rules and procedures:

There will be paperwork and more paperwork. There will be doctor appointments, phone calls, and interviews to endure. Still, anyone who has paid into social security for a certain period of time may have a right to expect social security disability benefits. But without an attorney who understands the complex rules and processes that can lead to a successful filing, claimants often face denied or reduced claims that do not meet their needs.

Compassionate support:

Individuals filing for social security disability or fighting insurance companies must simultaneously deal with the daily challenges of their physical or mental conditions and complex legal issues. The attorneys and staff at Eric Buchanan & Associates, PLLC understand the unique issues you face and we possess the expertise to successfully guide you through the entire process. We will strive to answer your questions promptly and provide the full support and resources to go through a stressful and confusing situation with a minimum of distress.

We are a dedicated team of disability insurance attorneys and will be happy to discuss any of these issues with you. For more information and assistance in collecting the full benefits from your disability insurance coverage, call us toll free at (877) 634-2506, or contact us online today.